Traumatic Injuries

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Dislodged (Luxated) Teeth

Luxated teeth

In the case of an injury, a tooth may be pushed sideways, into, or out of its socket.  Root canal treatment is usually needed for permanent teeth that have been dislodged and should be started a few days after the injury.

*Please note: Children between the ages of seven and twelve may not need root canal treatment since their teeth are still developing.  For those patients, Dr. Duggan will monitor the healing process carefully and intervene immediately if any unfavorable changes appear. Dr. Duggan will discuss procedures other than root canals with you, which can help young teeth.

Knocked-Out (Avulsed) Teeth

Avulsed teeth

If a tooth is completely knocked out of your mouth, time is of the essence. The tooth itself should be handled very gently.  Take great care to avoid touching the root surface itself. If it is dirty, quickly and gently rinse it in water. Do not use soap or any other cleaning agent, and never scrape or brush the tooth. If you are able, the tooth should be placed back into its socket as soon as possible. The less time the tooth is out of its socket, the better the chance for saving it.  Call a dentist immediately!

If you cannot put the tooth back in its socket, it needs to be kept moist by special solutions that are available at many local drugstores (such as Save-A-Tooth). If those solutions are unavailable, you should put the tooth in milk.  Doing this will keep the root cells in the tooth alive a little longer.  Another option is to simply put the tooth in your mouth between your gum and cheek. Do not place the tooth in regular tap water because the root surface cells will not tolerate tap water and the tooth will be further damaged.
The length of time the tooth was out of the mouth and the way the tooth was stored will determine the chances of saving the tooth. Again, immediate treatment is essential. Taking all these factors into account, Dr. Duggan may discuss other treatment options with you.

Do traumatic dental injuries differ in young children?

Chipped primary (or “baby”) teeth can be aesthetically restored. Dislodged primary teeth can sometimes re-position. However, primary teeth that have been knocked out typically should not be replanted. This is because the replantation of a knocked-out primary tooth may cause further and permanent damage to the underlying permanent tooth that is growing inside the bone.

Children’s permanent teeth that are not fully developed at the time of the injury need special attention and careful follow up, but not all of them will need root canal treatment.  In an immature permanent tooth, the blood supply to the tooth and the presence of stem cells in the region may enable Dr. Duggan to stimulate continued root growth.

Will the tooth need any special care or additional treatment?

Several factors determine the long-term health and function of the tooth: the nature of the injury, the length of time from injury to treatment, how the tooth was cared for after the injury, and your body’s response. Timely treatment is particularly important with dislodged or knocked-out teeth in order to prevent root resorption.

Resorption

Resorption occurs when your body (through its natural defense mechanisms) begins to reject your own tooth in response to the traumatic injury. Following the injury, you should return to your dentist or endodontist to have the tooth examined and treated at regular intervals for up to five years to ensure that root resorption is not occurring and that the surrounding tissues continue to heal.  Please note that some types of resorption are untreatable and result in extraction of the tooth.